This comprehensive guide will help you overcome confusion about the different types of CPAP masks, and help you pick the best CPAP mask for your needs.
Table of Contents
1. The Anatomy of a Typical Mask | 2. Different Types of CPAP Masks | 3. Common Problems and How to Solve Them | 4. How to Choose a Mask for Your Sleeping Position | 5. Tips for Mouth Breathers | 6. Ways Women Can Make the Most of Their CPAP Therapy | 7. Research Highlights
What is a CPAP Mask?
A CPAP Mask is commonly worn over the mouth, nose, nose and mouth, or at the base of each nostril, and it’s how the CPAP machine does its work. When the CPAP machine runs, it delivers the therapy air from the machine through a tube (usually called a hose) and connects with the face through a mask1.
The mask’s job is to create an airtight seal so that the pressure stays the same as it travels down the airway. This article is meant to provide an in-depth examination of CPAP masks, covering the basics to more advanced topics, like what masks work best for your preferred sleeping position.
Are you trying to explore all the different types of CPAP masks but getting confused? Or maybe you aren’t 100% committed to your current mask and are trying to find one that will accommodate your lifestyle needs.
In this article, we will break down all the different types of masks so you can choose the best mask that will work for your Sleep Apnea treatment. Once you know the type of mask you want, check out “Comparing Different CPAP Masks” to get recommendations on some of the best CPAP masks on the market.
Anatomy of a Typical Mask
Most CPAP masks have three main components:
- Mask Frame
- Mask Headgear
- Mask Cushion
The mask frame holds the mask cushion and is where the mask headgear attaches. The most common masks use clips hold your headgear in place and some masks have ‘quick-clips’ that allow you to quickly remove the headgear without having to readjust it when you put it back on.
Mask cushions are responsible for providing a tight seal to minimize air leaks. There are different types of cushions, the most common types are silicone, inflatable (commonly referred to as cloth), gel, and foam.
The Different Types of CPAP Masks
A nasal mask2 sits on the bridge of the nose usually covering the entire nose or the bottom half of the nose. The nasal mask is commonly held in place by a four-point headgear that attaches to the frame. Irritation with a nasal mask can occur on the bridge of the nose where the mask sits.
If you want to compare a few popular nasal masks on the market then take a look at “Comparing the Best CPAP Masks” to see what nasal masks you may be interested in.
Nasal Pillow2 CPAP masks create a seal at the base of the nostril where the cushion sits. This mask is the least invasive and provides a clear field of vision, ideal for reading or watching TV. For men that have facial hair, the nasal pillow mask will be a good option.
However, there are times when a nasal pillow won’t be the best option. For instance, if your prescription has a high pressure setting, or you suffer from nasal allergies, then this probably won’t be the best type of mask for you.
Sometimes irritation can happen at the opening of the nostril both on the inside of the nose and the outside. If this is happening, first check to make sure your nasal pillow isn’t too big and then grab some CPAP moisture therapy cream until your nostrils get adjusted.
Full Face masks2 seal around your nose and mouth, with cushions commonly in the shape of a triangle, and are held in place by four-point headgear.
These masks are great for people who breathe through their mouth and don’t want to use a nasal mask with a chinstrap.
The downside of a full face mask is that they are usually more heavy and bulky because they cover both the nose and mouth. Recently, CPAP equipment manufacturers (companies that produce CPAP masks and machines) ResMed and Philips Respironics have both released full face masks that offer a greatly improved field of vision.
Some models even offer a clear field of vision and a comfortable design. The most common reasons why you would need a full face mask are:
- You have chronic sinus issues or allergies and it is not possible to breathe solely through your nose.
- Your mouth drops open during sleep and using a chinstrap with a nasal type of mask wasn’t working for you.
Many people love full face masks, but some researchers have found evidence that full face masks can lead to lower levels of compliance, versus using a nasal or nasal pillow mask3. If you try a full face mask, and it’s not working, you can switch to a nasal mask or a nasal pillow mask if you use a chinstrap.
Hybrid full face masks provide the functionality of a full face mask with much less bulk. This CPAP mask design combines the seal of nasal pillows at the nostril openings and also has a mouth seal. The clear field of vision is why many people choose this mask style, and why hybrid masks are growing in popularity.
There is no forehead support that is needed so users have a clear field of vision. If your nose isn’t familiar with nasal pillows then you may experience some irritation at the opening of the nasal passages until the adjustment period wears off.
Nasal Prong masks seal and deliver air inside the nasal openings of your nose. Nasal Prong masks are similar to nasal pillows, but the prong will rest deeper inside the nostril and inflate slightly against the walls of the nostril to create a seal with pressure. This is different from a nasal pillow mask which creates a seal by resting against the nostril opening.
Nasal Prong CPAP masks are held in place by a headgear that is worn on the top of the head. To prevent dryness and make Sleep Apnea therapy more tolerable, it is highly recommended to use heated humidification.
Oral CPAP masks use an oval cushion to seal around the mouth and deliver air through two inlets inside the mask. An inside flap rests between your teeth and lips and a second curls over your lips to keep the mask stable.
This design is great for users who experience frequent nasal congestion but those without congestion find that the air that is blown in their mouth sometimes escapes through the nose and dries up their airway.
Total Face CPAP masks seal in a large oval around the entire face to include, nose, mouth, and eyes and are held in place by four-point headgear. Some people leak CPAP air through the corners of their eyes when they receive Sleep Apnea treatment. If this happens then other types of masks will not function properly and a Total Face Mask should be considered.
Other special circumstances could be if a patient has a facial condition that prevents the use of a nasal or full face mask. Like a full face mask, a total face mask equalizes the pressure so the air treatment is even, but this mask encompasses the entire face and will cover any area where air might escape, such as the eyes.
Common Problems and How to Solve Them
Red Marks: If you’re getting red marks on your face, it’s probably because the mask is too tight. Try loosening the straps and see if you still have a good seal. If not, consider looking for a new mask4.
Mask Leaks: Mask leaks are a common annoyance among CPAP users. If the mask doesn’t seal, how can it do its job? For some, this can be rectified by using a product like mask liners which provide cloth padding between the mask and the face, which can improve comfort, but overall creates a better seal than if you don’t use one.
A mask liner can also help silicone masks to last longer, as human perspiration tends to break down the silicone over time4.
Dried Out Nose and Mouth: If you find your nose or mouth is dried out from your therapy, there’s an easy way to fix it. If you’re not using humidification, you should be. Humidification will add moisture back into your therapy air, reducing the amount of dryness that you experience, and it’s a great way to increase comfort4.
- Masks – Every 6 to 12 Months
- Mask Cushion – Every 3 to 6 Months
- Mask Headgear – Every 6 to 9 Months
How To Choose a CPAP Mask for Your Sleeping Position
Choosing a CPAP mask can seem daunting when you’re new to Sleep Apnea treatment. In addition to knowing if you sleep with your mouth open or closed, you should also pay close attention to how you sleep. Do you lay on your back? Do you lay on your side? If you have a specific mask in mind, you may find out your favorite sleeping position may not work for that mask!
Let’s break down sleeping positions and talk about some of the masks that may work for those positions.
Best Masks for the Side Sleeper
Approximately 41% of all adults are side sleepers, and the position is preferred by many women.
Side sleepers need a CPAP mask that can withstand a little pressure from a pillow, and require lots of flexibility. It’s also helpful to have a mask that delivers air under the nose, as opposed to having a mask that covers the bridge of the nose.
Best Masks for the Log
About one in six people sleep like a log– literally! This means the person sleeps on their side, with both arms lying to their side. Log sleepers technically sleep on the side, so they need to be careful not to have the pillow dislodge the mask. Log sleepers need to have a mask that is soft– and flexible.
It may also be helpful for a log sleeper to have a CPAP pillow to help accommodate the CPAP mask.
Best Masks for the Yearner
Yearners sleep like Logs, but extend their arms out, almost as if in the beginning of an embrace. Yearners are so similar to Logs and Side Sleepers, that any mask that works well for either type of sleeper will work for Yearners too.
Best Masks for the Soldier Sleep Position
One in 12 will sleep in this rigid sleeping style. Called the “Soldier” (because it’s the sleeping position equivalent of standing at attention), the sleeper sleeps with arms at the side and lies flat on his or her back.
Sleeping on your back is the worst possible sleeping position for Sleep Apnea. Sleeping on your back allows gravity to help close the airway, making it harder for your CPAP machine to do its job.
Ideally, a Soldier would be best served to try a different sleeping position as this could help improve Sleep Apnea symptoms. If you’re unable to try a different sleep position, you need to find a compatible mask. Ideally, you wouldn’t want a mask where the hose connects at the back of the head. This could make it impossible to sleep on your back.
You would want a hose connection in the front or top of the head, and wouldn’t want to deal with buckles or straps at the back of the head either.
Best CPAP Mask for the Freefaller
Freefallers sleep on their stomach while grasping the pillow with both hands. About 5 – 7% of the population sleeps like a Freefaller. Nasal pillow masks inflate on their own and generally offers a smaller and more minimal design than any other type of mask.
You’ll also need a mask in which the hose connects to the top of the head or the back. The majority of masks feature a hose connection in the front.
Here are a few masks that may work for Freefallers:
Best Masks for the Starfish
Starfish are sleepers that lay on their backs like the soldier, but also grab ahold of the pillow during sleep. Only one in twenty people sleep like a starfish and can use any mask that would work for the Soldier. To review:
For more information, please see the following resource: How to Choose a CPAP Mask for Your Sleeping Position
CPAP Solutions for Mouth Breathers
Do you have trouble breathing through your nose at night? Do you breathe through your mouth when you sleep? If so, you may be exposing yourself to additional health problems you may not be aware of! Mouth breathing has been linked to periodontal disease, bad breath, and cognitive challenges.
Ways to Stop Mouth Breathing
There’s a couple of different things you can do to make CPAP compatible with mouth-breathing. Let’s go over a few ideas:
Use a Chinstrap
Some people are just predisposed to breathe out of their mouth while they sleep, partly due to the mouth falling open during sleep.
Many people are able to overcome this by using a chinstrap. A chinstrap is a specially designed cloth strap that wraps under the chin and over the top of the head to keep the mouth closed while you sleep, thus forcing you to breathe through your nose.
It’s the most common way that mouth breathers can adjust to sleeping with a nasal mask, and many people use one.
Keeping the Sinuses Clear
Sometimes people breathe through their mouth because the sinuses are clogged and they can’t breathe through their nose. If this is the case with you, you may want to consider investing in a nasal rinse, designed to clear the sinuses and make it so that you can breathe through the nose more easily.
Keeping a full face mask on hand during allergy season can also help when the sinuses get clogged frequently.
CPAP Masks for the Mouth Breather
The good news for CPAP mouth breathers is that there is a special type of mask that targets mouth breathers specifically. It’s called a full face mask, and it covers the nose and the mouth and gives mouth breathers the option of breathing through the nose or the mouth.
This way you don’t need to try to force yourself to breathe through the nose or mouth, you can just breathe as you normally do.
It’s great that this option exists for mouth breathers, and it’s a big reason that full face masks are so popular.
For more information about CPAP and mouth breathing, please see the following article: Using a CPAP and Mouth Breathing at Night
4 Ways Women Can Make the Most of Their CPAP Therapy
Women who are new to CPAP therapy may not realize they have specialized options when it comes to their Sleep Apnea treatment. Many CPAP manufacturers have products that cater to female customers, and take care of problems like “headgear hair”.
When getting used to CPAP therapy, there are a few things that you can do to make your therapy a success.
Get the Right Mask Size
Many CPAP manufacturers make petite sizes that adapt to some women’s facial features. It’s important to get a mask that’s truly the right fit, as that will help with a lot of things– especially comfort and the quality of the mask seal.
Fit is everything when it comes to masks, and that’s why many product pages for masks feature mask sizing guides. They can help measure your face to be sure that you’re getting the best fit. Getting the right fit for your mask is the most important part of your CPAP therapy.
The mask is how the therapy works, and if you don’t have a good seal, you can’t treat Sleep Apnea. Depending on your preferred mask style, you may need to try a few different masks before you’ll get the fit you need.
Get Comfortable With Your Equipment
It can be difficult to get used to your new CPAP equipment. Sometimes users complain of claustrophobia or feel like the mask is too tight. Getting used to the new mask can help. We recommend trying it out before you actually need it to sleep. Just wearing it for an extended period of time can help you become more comfortable and it will become easier to use.
It may take some time to get used to the mask, but when you do, it will make all the difference in the world. It can also be helpful to make use of the ramp feature on your CPAP machine, as this feature gradually increases the pressure over a period of around 45 minutes.
By the time ramp gets you up to your optimum pressure, you may be asleep. The ramp up feature is used by a lot of people new to CPAP therapy, and it’s a good way to get comfortable with your equipment.
Is Humidification Necessary?
Humidification isn’t necessary for CPAP therapy to work. You get the same benefit from the therapy whether you use humidification or not. Humidification is important because it keeps the air you’re breathing moist, and that in turn prevents your sinuses and throat from drying out from the therapy, and is an important part of sticking with your therapy4.
For this reason, many of you may find that humidification is a required accessory, and many people order a humidifier with their first machine.
If you use a humidifier, you may also need a heated hose. A heated hose works to prevent rainout, which is the formation of condensation and water droplets inside of the hose. These water droplets can splash users with water during the night, leading to an uncomfortable sensation. A heated hose or a hose cover can work to help reduce these instances.
Humidification is a great way to help you with your therapy and keep you using it. CPAP therapy only works if you use your machine so humidification may be a feature that you want to get from the beginning to ensure your therapy is a success.
Accessorize Your Equipment
There are also other little ways you can improve comfort. If red marks from wearing your mask are a problem, you can get strap pads that add a little cushion to the touchpoints on the face, which can help reduce red marks. If you’re feeling pressure on the bridge of the nose, you can try using nasal pads, to add comfort there as well.
Research Highlights for CPAP Masks
- Nasal Pillows May Make it Easier to Stick With Your Therapy, Study Finds2 According to researchers, writing for the medical journal Sleep Disorders, when looking at patients with poor compliance rates for CPAP therapy, using a nasal pillow mask improved their odds of sticking with therapy as high as 60% in some cases. The medical journal Sleep Medicine3 reached a similar conclusion in their article, published in 2018
- Full Face Masks Require a Higher Pressure to Work Than Nasal or Nasal Pillow Masks, Study Finds5 According to the Journal of Clinical Sleep Medicine, researchers found that full face mask users may require a higher pressure to get the same benefit than nasal or nasal pillow masks.
- Full Face Masks May Make it More Difficult to Stick With Treatment6 According to Jornal Brasileiro de Pneumologia, a Brazillian medical journal, using a full face mask may make it more difficult to stick with and be successful with your treatment.
What is Your CPAP Mask Experience? We want to hear from you!
What have you found the most confusing about all the different CPAP mask options? What tips or tricks would you recommend someone try when they are selecting a CPAP mask? Leave your comments below and let us know.
1. Neuzeret, Pierre‐Charles. Morin, Laurent. Impact of Different Nasal Masks on CPAP Therapy for Obstructive Sleep Apnea: a Randomized Comparative Trial. Published in “The Clinical Respiratory Journal”, January 18, 2016. Accessed August 13, 2018.
2. Wimms, Alison, et al. Impact of a New Nasal Pillows Mask on Patients’ Acceptance, Compliance, and Willingness to Remain on CPAP Therapy. Published in the medical journal “Sleep Disorders”, August 25, 2016. Accessed August 13, 2018.
3. Lanza, Andrea, et al. Continuous Positive Airway Pressure Treatment with Nasal Pillows in Obstructive Sleep Apnea: Long-Term Effectiveness and Adherence. Published in the medical journal “Sleep Medicine”, January 2018. Accessed August 13, 2018.
4. Atwood, Jr, MD, Charles. Sleep and CPAP Adherence. Published on the National Sleep Foundation’s official website. Accessed August 13, 2018.
5. Edwards, Bradley, Ph.D, et al. Oronasal Masks Require a Higher Pressure than Nasal and Nasal Pillow Masks for the Treatment of Obstructive Sleep Apnea. Published in the medical journal “Journal of Clinical Sleep Medicine” September 15, 2016. Accessed August 13, 2018.
6. Fernanda Madeiro Leite Viana, et al. Impact of the Type of Mask on the Effectiveness and Adherence to Continuous Positive Airway Pressure for Obstructive Sleep Apnea. Published in the medical journal “Jornal Brasileiro de Pneumologia” Nov-Dec 2014. Accessed August 13, 2018.
Daniela has researched and published over 60 articles covering topics that aim to inform and empower people living with Sleep Apnea. As an avid reader and researcher, Daniela continues to grow her knowledge about Sleep Apnea and CPAP therapy everyday with the help of coworkers, CPAP.com customers, and members of other CPAP communities online.